Syndrome of 'inappropriate secretion of thyroid-stimulating hormone' by partial target organ resistance to thyroid hormones.
A 74 year old woman was found to have elevated serum thyroid-stimulating hormone (TSH) levels and elevated serum thyroid hormone levels, with clinical euthyroidism. There was no evidence of a pituitary tumor. TSH levels increased substantially during methimazole therapy. Administration of dexamethasone was followed by a prompt fall in serum TSH levels. Triiodothyronine (T3) was administered over a period of 20 days in doses from 25 micrograms to as much as 100 micrograms daily causing a rise in serum T3 above 700 ng/100 ml, a decline of T4 and a blunting of the response to thyrotrophin-releasing hormone (TRH), with normal metabolic responses (pulse rate, photomotogram, cholesterol). These results suggest that the patient's disorder is due to partial target organ resistance to thyroid hormones.
D000368:Aged; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008713:Methimazole / Q000627:therapeutic use; D013577:Syndrome; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood / Q000378:metabolism*; D013973:Thyrotropin-Releasing Hormone / Q000494:pharmacology; D013974:Thyroxine / Q000097:blood; D013975:Thyroxine-Binding Proteins / Q000032:analysis; D014284:Triiodothyronine / Q000097:blood / Q000494:pharmacology
D013963:Thyroid Hormones; D013975:Thyroxine-Binding Proteins; D014284:Triiodothyronine; D008713:Methimazole; D013973:Thyrotropin-Releasing Hormone; D003907:Dexamethasone; D013972:Thyrotropin; D013974:Thyroxine